24-05-2025
Suffering in silence: the rapidly rising disease impacting Australians
In her first year of university, when Natasha Jiwani should have been revelling in her new-found independence, she started to experience constant abdominal pain. "I straight after finishing high school, first year of university would get severe abdominal pain to the point where I would wake up with it and go to sleep with it. No one could diagnose what it was." Eventually, Natasha was diagnosed with Crohn's disease. "The overall experience was quite different. So, walking into a gastroenterologist waiting room, I'd look around and I was the only one that was in my close to 20's. Everybody else, the average age was 60 onwards, so there was a lot of confusion." Crohn's disease and ulcerative colitis both fall under the umbrella term of Inflammatory Bowel Disease, or IBD — an autoimmune disease where the body's immune system attacks the gut. Crohn's disease can cause inflammation anywhere in the digestive system, though it usually affects the bowels. Ulcerative colitis, often referred to simply as "colitis", can cause inflammation and ulcers in the colon and rectum. Vincent Ho, a gastroenterologist at Western Sydney University, says both conditions cause multiple symptoms including diarrhea and abdominal pain, though to others they remain invisible. "People with inflammatory bowel disease may look perfectly fine but are actually suffering from the symptoms of inflammatory bowel disease, which can be quite severe in many cases and affect their daily life."
The number of Australians living with I-B-D is rapidly on the rise, increasing from 100,000 a decade or so ago to around 180,000 today, according to a recent State of the Nation Report.
That number is expected to rise to 200,000 in the next 10 years. Doctor Ho says the rates of IBD in Australia are among the highest in the world. "Over 65, we're seeing more cases, but we're also seeing cases of inflammatory bowel disease in young children as well. And there are a number of cases of what we call very early onset in inflammatory bowel disease where children can get it a younger than six years of age." Dr Ho say, while it's largely unknown how this inflammation arises, we are starting to learn more about its causes. "Some risk factors in the environment include exposure to tobacco smoke, the use of antibiotics, the use of certain drugs like non-steroidal anti-inflammatory drugs, for example Nurofen, Voltaren, those sorts of drugs. We know that some types of infections can increase the risk of developing inflammatory bowel disease." Another risk factor is diet. One recent world-first pre clinical study, by the Walter and Eliza Hall Institute of Medical Research, shows how eating just a few meals high in saturated fats, can cause inflammation in the body. Those foods can also weaken the production of a crucial protein called IL-22, which helps fight this inflammation. Mice were used in this research, which also reveals something that excited researchers: while saturated fats suppress IL-22 production, unsaturated fats, found in nuts and avocados, actually boost the protein's production. Dr Ho says this provides immense hope for people living with chronic inflammatory diseases like IBD. "We know that certain types of foods, a high-quality diet, for example, reaching fruit, vegetables, fish, and other fibre sources is considered to be a protective factor when it comes to inflammatory bowel disease." Natasha has found eating well has had a huge impact on her symptoms. "I know that if I'm living off fast food for a week as opposed to making healthy at home meals, my Crohn's is a lot better in that latter thing because my body's healthier and it's ensuring that my body's not flaring up with what I'm eating." While IBD is a chronic condition with no cure, it can be managed with treatment. Early diagnosis is important, with symptoms including abnormal bowel movements and the presence of mucus or blood in stools, as well as abdominal discomfort, bloating and flatulence. Leanne Raven, CEO of Crohns and Colitis Australia, says greater awareness around I-B-D will also help when it comes to diagnosis, support and treatment. "Because it's below the belly button, people don't necessarily talk about it. So, a lot of people become quite isolated in trying to manage their conditions. So, we're trying to shatter the IBD silence through raising awareness of and encouraging people to have conversations." Natasha says while there is less stigma and embarrassment around I-B-D than ever before, more people need to talk about it.
"I think what's really also important is clarifying the support that's available. I definitely do think awareness, raising funds, raising funds to help with finding a cure potentially for this disease as well would be amazing."
